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Association of positive airway pressure adherence with use of antihypertensive drugs in patients with sleep apnoea

D. Jaffuel,Erika Nogué,François Roubille,J. Mallet,S. Bailly,F. Goupil,Audrey Thomas,Carole Hervé,P. Masson,A. Bizieux-Thaminy,M. Blanchard,S. Kerbrat,A. Sabil,W. Trzepizur,Camille Roubille,Sarah Skinner,Arnaud Bourdin,Nicolas Molinari,F. Gagnadoux

Published 2025 in ERJ Open Research

ABSTRACT

Background The impact of positive airway pressure (PAP) therapy on the use of oral antihypertensive drugs (OAHDs) in patients with obstructive sleep apnoea (OSA) remains unclear. This study aimed to evaluate the association between PAP use and the delivery of OAHDs. Methods Data from the Pays de la Loire Sleep Cohort were linked with the French health insurance database to quantify OAHD delivery in patients with hypertension at the initiation of PAP therapy. The primary end-point was the change in OAHD score, reflecting the number of OAHD classes delivered. PAP use groups were defined as: termination, 0–<4 h·day−1, 4–<6 h·day−1 and ≥6 h·day−1. Results The study included 2205 OSA patients (median (Q1–Q3) apnoea–hypopnea index of 39 (30–55) events·h−1), of whom 68% were male. The median age was 61 (54–68) years, the body mass index (BMI) was 32.42 (28.95–36.43) kg·m−2 and the Epworth score was 10 (6–13). After 1 year of PAP, the mean±sd OAHD score decreased from 2.16±1.11 to 2.13±1.18 with no significant difference between PAP use groups. Respectively, 11.93% and 11.07% of patients experienced a decrease or increase in OAHD score, with no significant difference between PAP use groups. Multivariate analysis revealed that an increase in OAHD score was significantly positively associated with age, usage of calcium channel blockers and number of consultations. A decrease in OAHD score was significantly associated with baseline OAHD score, number of consultations, use of loop diuretics and a decrease in medication possession ratio. Conclusion PAP use is not associated with a change in OAHD score after 1 year. Shareable abstract In obstructive sleep apnoea patients with hypertension, initiating positive airway pressure therapy does not alter the number of oral antihypertensive medications required after 1 year https://bit.ly/3WTwCig

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